Provider Demographics
NPI:1972653442
Name:DUNCAN, DEAN M (PHD, LPC, LCPC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:M
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD, LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4676 COMMERCIAL ST SE # 271
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1902
Mailing Address - Country:US
Mailing Address - Phone:503-871-6857
Mailing Address - Fax:503-588-8103
Practice Address - Street 1:1845 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5203
Practice Address - Country:US
Practice Address - Phone:503-871-6857
Practice Address - Fax:503-588-8103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC-1584101YP2500X
IL180-001241101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR20-1064838OtherEIN